Chest tube management following pulmonary lobectomy: change of protocol results in fewer air leaks
Much controversy exists regarding the management of chest tubes following pulmonary lobectomy. The objective of this study was to analyse the effect of a new chest tube management protocol on clinical features, such as postoperative air leak, drain characteristics, 30-day postoperative complications...
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Published in | Interactive cardiovascular and thoracic surgery Vol. 12; no. 1; pp. 28 - 31 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
England
01.01.2011
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Abstract | Much controversy exists regarding the management of chest tubes following pulmonary lobectomy. The objective of this study was to analyse the effect of a new chest tube management protocol on clinical features, such as postoperative air leak, drain characteristics, 30-day postoperative complications and length of hospital stay. We retrospectively analysed 133 patients who underwent pulmonary lobectomy, from January 2005 to December 2008. A new chest tube protocol was introduced on 1 January 2007 and included placement of a single chest tube and early conversion to water seal. The chest tube was removed when air leak had resolved and (non-chylous) fluid drainage was <400 ml/day. The results of patients in the old (n=68) and the new protocol (n=65) were compared. In the new protocol group the median duration of air leak and duration of chest tube drainage declined significantly. Also the length of hospital stay decreased significantly to a median of eight days. The number of reinterventions and 30-day morbidity and mortality rates did not differ significantly. Our data suggest that placement of a single chest tube and early conversion to water seal decreases the duration of air leak and chest tube drainage and length of hospital stay. |
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AbstractList | Much controversy exists regarding the management of chest tubes following pulmonary lobectomy. The objective of this study was to analyse the effect of a new chest tube management protocol on clinical features, such as postoperative air leak, drain characteristics, 30-day postoperative complications and length of hospital stay. We retrospectively analysed 133 patients who underwent pulmonary lobectomy, from January 2005 to December 2008. A new chest tube protocol was introduced on 1 January 2007 and included placement of a single chest tube and early conversion to water seal. The chest tube was removed when air leak had resolved and (non-chylous) fluid drainage was <400 ml/day. The results of patients in the old (n=68) and the new protocol (n=65) were compared. In the new protocol group the median duration of air leak and duration of chest tube drainage declined significantly. Also the length of hospital stay decreased significantly to a median of eight days. The number of reinterventions and 30-day morbidity and mortality rates did not differ significantly. Our data suggest that placement of a single chest tube and early conversion to water seal decreases the duration of air leak and chest tube drainage and length of hospital stay. Much controversy exists regarding the management of chest tubes following pulmonary lobectomy. The objective of this study was to analyse the effect of a new chest tube management protocol on clinical features, such as postoperative air leak, drain characteristics, 30-day postoperative complications and length of hospital stay. We retrospectively analysed 133 patients who underwent pulmonary lobectomy, from January 2005 to December 2008. A new chest tube protocol was introduced on 1 January 2007 and included placement of a single chest tube and early conversion to water seal. The chest tube was removed when air leak had resolved and (non-chylous) fluid drainage was <400 ml/day. The results of patients in the old (n=68) and the new protocol (n=65) were compared. In the new protocol group the median duration of air leak and duration of chest tube drainage declined significantly. Also the length of hospital stay decreased significantly to a median of eight days. The number of reinterventions and 30-day morbidity and mortality rates did not differ significantly. Our data suggest that placement of a single chest tube and early conversion to water seal decreases the duration of air leak and chest tube drainage and length of hospital stay. |
Author | Keemers-Gels, Mariël E van den Wildenberg, Frits J H Barendregt, Wouter B Joosten, Joris J A Bertholet, Joost W M |
Author_xml | – sequence: 1 givenname: Joost W M surname: Bertholet fullname: Bertholet, Joost W M email: jwmbertholet@gmail.com organization: Division of Lung Surgery, Department of General Surgery, Canisius-Wilhemina Hospital, PO Box 9015, 6500 GS Nijmegen, The Netherlands. jwmbertholet@gmail.com – sequence: 2 givenname: Joris J A surname: Joosten fullname: Joosten, Joris J A – sequence: 3 givenname: Mariël E surname: Keemers-Gels fullname: Keemers-Gels, Mariël E – sequence: 4 givenname: Frits J H surname: van den Wildenberg fullname: van den Wildenberg, Frits J H – sequence: 5 givenname: Wouter B surname: Barendregt fullname: Barendregt, Wouter B |
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SubjectTerms | Aged Chest Tubes Drainage - adverse effects Drainage - instrumentation Female Humans Length of Stay Lung Neoplasms - pathology Lung Neoplasms - secondary Lung Neoplasms - surgery Male Middle Aged Netherlands Pleural Effusion - etiology Pleural Effusion - surgery Pneumonectomy - adverse effects Pneumothorax - etiology Pneumothorax - prevention & control Retrospective Studies Time Factors Treatment Outcome |
Title | Chest tube management following pulmonary lobectomy: change of protocol results in fewer air leaks |
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